Nursing Fundamentals Study Notes
Objectives of Nursing Practice
Explain how standards of practice affect nursing care.
Discuss how societal factors affect the development of professional roles and responsibilities in nursing practice.
Discuss the roles and career opportunities for professional nurses.
Discuss the influence of social, historical, political, and economic changes on nursing practices.
Discuss how advances in nursing science and evidence-based practice improve patient care.
Discuss the educational programs available for professional registered nurse (RN) education.
Explain how professional nursing organizations affect both the profession and nursing standards of care.
Key Terms in Nursing
Advanced Practice Registered Nurse (APRN): A nursing professional with advanced qualifications and skills.
American Nurses Association (ANA): A professional organization representing nurses in the United States.
Caregiver: A primary role of nurses responsible for caring for patients’ health needs.
Certified Nurse-Midwife (CNM): An APRN specializing in midwifery, educated to provide care during pregnancy and childbirth.
Certified Registered Nurse Anesthetist (CRNA): An APRN specializing in anesthesia and pain management.
Clinical Nurse Specialist (CNS): An APRN with advanced knowledge in a specialized area of clinical practice.
Code of Ethics: A set of principles guiding the ethical practice of nursing.
Continuing Education: Ongoing education for nurses to remain competent in their field.
Genomics: The branch of biology focused on the study of genomes and their impact on health.
In-Service Education: Training programs designed to enhance the skills of nursing staff within their organization.
International Council of Nurses (ICN): A federation of nurses’ associations worldwide, promoting nursing excellence.
Nurse Administrator: A nurse with a role in management and administration in healthcare settings.
Nurse Educator: A nursing professional involved in teaching and training future nurses.
Nurse Practitioner (NP): An APRN with advanced clinical training who provides various healthcare services.
Nurse Researcher: A nurse focusing on research to innovate and improve nursing care.
Patient Advocate: A nurse who promotes and protects patients’ interests and rights.
Professional Organization: Groups advocating for the interests and advancement of nursing.
Registered Nurse (RN): A nurse who has completed the necessary education and has passed the NCLEX examination.
The Art and Science of Nursing
Nursing is characterized as both an art and a science:
Art: Involves compassion, care, and respect for patient dignity within a learning environment that evolves through experience.
Science: Represents discipline-specific knowledge acquired through research and inquiry aimed at improving care outcomes.
The aim of nursing science:
To expand knowledge about human experiences through research and evidence.
Dynamics of the Nursing Profession
The nursing profession is constantly evolving due to:
Economic factors
Changes in healthcare systems
Public health emergencies
The Gallup poll illustrates nurses' public perception as the most ethical and trustworthy professionals since 1999, with only one exception in 2001.
Patient-Centered Practice
Nurses must focus on a diverse range of patients, including individuals, families, and communities, to meet various health care needs.
Examples of fulfilling roles include:
Helping a young mother learn parenting skills.
Assisting older adults in maintaining independence at home.
Supporting family caregivers in end-of-life care and symptom management.
Nursing is defined not just by skills but by critical thinking, clinical judgement, and professional accountability.
Career Opportunities in Nursing
Potential career paths include:
Clinical practice
Education
Research
Management and administration
Entrepreneurship
Role of Professional Nursing Organizations
Promote the significance of nursing in improving health equity and access to quality care.
The Future of Nursing: Campaign for Action supports initiatives to create diverse, educated nursing workforces.
The National Academies of Sciences, Engineering, and Medicine (NASEM) collaborates with nursing leaders to explore health equity initiatives.
Integration of Science and Art in Nursing Practice
Nursing requires a blend of knowledge and compassionate approaches to patient care, incorporating best practice standards and evidence-based findings.
Example of best practice in action includes:
Applying evidence-based guidelines from the Wound, Ostomy, and Continence Nurses Society (WOCN) for pressure injury care.
Levels of Nursing Proficiency (Benner's Model)
Novice: Limited experience; relies on rule-based learning.
Advanced Beginner: Some situational experience; recognizes meaningful aspects of nursing care.
Competent: 2-3 years of experience; understands specific patient needs and anticipates care requirements.
Proficient: More than 2-3 years of experience; sees patients' clinical situations holistically.
Expert: Diverse experience; intuitive grasp of clinical problems.
Standards of Practice and Ethical Guidelines
Professional standards of practice and nursing code of ethics must guide nursing practice.
Incorporates knowledge from various sciences and nursing theories.
Definition by the ANA:
Nursing is a practice focusing on protection, promotion, optimization of health, prevention of illness, and alleviation of suffering.
Advocates for individuals and communities recognizing the interconnectedness of humanity.
Professional Practice Standards by the ANA
Assessment: Gathering relevant health data.
Diagnosis: Analyzing assessment data.
Outcomes Identification: Identifying expected health outcomes.
Planning: Developing strategies to achieve expected outcomes.
Implementation: Executing care plans.
Evaluation: Assessing progress towards goals.
Standards of Professional Performance
Ethics: Incorporation of ethical principles in practice.
Advocacy: Advocating for patients in all settings.
Respectful and Equitable Practice: Cultural humility and inclusiveness.
Communication: Effective communication in professional practice.
Collaboration: Working with healthcare consumers and stakeholders.
Leadership: Leading within the practice setting and profession.
Education: Commitment to ongoing learning and competence.
Scholarly Inquiry: Integrating research into practice.
Quality of Practice: Contributing to quality nursing practices.
Professional Practice Evaluation: Evaluating nursing practice effectiveness.
Resource Stewardship: Effective resource management in nursing services.
Environmental Health: Focus on safe environmental practices.
Code of Ethics in Nursing
Provides philosophical ideals guiding ethical practice. Incorporates personal values alongside established professional standards to shape nursing practice.
Professional Roles and Responsibilities
Nurses fulfill multiple roles including:
Caregiver: Support in health maintenance and recovery.
Advocate: Defense of patient rights and needs.
Educator: Teaching patients and families about health management.
Communicator: Building effective relationships with patients and colleagues.
Manager: Overseeing nursing staff and ensuring quality care delivery.
Advanced Practice Registered Nurses (APRN)
Definition: Nurses with advanced education and clinical training providing direct patient care.
Four main roles:
Clinical Nurse Specialist (CNS): Expert in a specialized area of practice.
Nurse Practitioner (NP): Provides advanced clinical care across settings.
Certified Nurse-Midwife (CNM): Specializes in prenatal and maternal health.
Certified Registered Nurse Anesthetist (CRNA): Focuses on anesthesia care.
Educational Pathways to Nursing
Prelicensure Programs
Two main pathways to RN licensure include:
Associate Degree in Nursing (ADN): Typically a 2-year program, focusing on basic nursing skills.
Bachelor of Science in Nursing (BSN): A 4-year degree with comprehensive training including sciences, arts, and humanities (IOM’s recommendation of 80% BSNs by 2020).
Graduate Education
Opportunities for pursuing master's or doctoral degrees to enhance nursing knowledge and skills, allowing for advanced professional roles.
Continuing Education
Essential for updating skills and knowledge; may be mandated by state licensing requirements.
Programs can be delivered in various formats including virtual and on-site training.
Nursing Practice Regulation
Licensure required to practice as an RN. All candidates must pass NCLEX-RN®.
Certification allows for specialization in specific practice areas.
Summary of Nursing Trends and Challenges
Addressing evolving healthcare needs through evidence-based practices, improved access to care, and a commitment to lifelong learning is central to nursing's future.
Emphasis on addressing healthcare disparities, cultural competence, and public health policy is critical in evolving nursing roles.